| NPI | 1447847934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA FONGER Billing Compliance Director 907-452-6251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2020-12-30 |